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Protect Needle Exchange Waiver Authority!!

Contact Representatives Young and Miller on Needle Exchange and Appropriations!!

June 24, 1997

A note from The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

A move from the conservative right threatens to remove the Secretary of Health and Human Services's (HHS) authority to lift the ban on federal funding of needle exchange programs. This attempt may come from members of the House Labor-HHS-Education Appropriations Subcommittee, which has jurisdiction over the bill in which the needle exchange language exists. The United States Conference of Mayors (USCM) recently passed a resolution calling on HHS Secretary Donna Shalala to lift the ban. During a speech to the USCM, President Bill Clinton stated that "we must identify sound public health strategies that enable local communities to address the twin epidemics of HIV and substance abuse." The USCM vote and President Clinton's supportive remarks may provide the impetus for Secretary Shalala to move forward in lifting the needle exchange ban.

We need your help in contacting Representatives Dan Miller (R-FL) and Bill Young (R-FL) telling them to protect the Secretary's waiver authority so she has the opportunity to lift the ban and allow states to use federal funds to operate needle exchange programs -- a proven HIV prevention intervention. It is important to contact them before the mark-up, scheduled for July 8th.

The House Labor-HHS-Education appropriations subcommittee is scheduled to mark up their bill July 8th. In addition to the needle exchange language, this bill contains critical federal AIDS programs such as the Ryan White CARE Act, HIV prevention programs at the Centers for Disease Control and Prevention (CDC), AIDS research at the National Institutes of Health (NIH), and substance abuse prevention and treatment at the Substance Abuse and Mental Health Services Administration (SAMHSA). The president has requested modest increases for all of these programs. It is absolutely essential that we push for the largest increases possible in the Labor-HHS-Education AIDS programs and that the Secretary's waiver authority be protected. Both Representatives Miller and Young will be critical to these efforts.


Since 1988 language has been included in the Labor-HHS-Education appropriations bill that prohibits states from using federal funding to operate needle exchange programs (NEPs) unless two criteria are met: 1) it is proven that these programs reduce HIV transmission rates, and 2) these programs do not increase illegal drug use. The language further places the authority with the HHS Secretary to lift the ban if and only if these two criteria are met. In February of this year, Secretary Shalala issued a report to Congress stating that NEPs are an effective means of HIV prevention in injection drug using populations, their sexual partners, and children, and further that there is little compelling evidence to show that they increase or encourage illegal drug use. This report came on the heels of a National Institutes of Health (NIH) consensus panel conclusion that NEPs can and should play an important role in HIV prevention. Needle exchange programs exchange sterile needles for used ones to prevent the sharing of injection equipment and the accompanying risk of transmission of HIV and other blood-borne diseases. The programs safely dispose of the needles and offer a variety of related services to participants, including referrals to drug treatment and HIV counseling and testing. More than 100 NEPs operate in 40 over U.S. cities in 28 states. The programs operate under variety of legal and tolerated mechanisms including exemptions to state statutes, such as health department waivers or local states of emergency, but without the aid of federal funds.

Over one-third of all documented adult AIDS cases in this country can be linked to injection drug use, and it is estimated that almost half of all AIDS cases will be attributable to injection drug use by the year 2000. Studies have proven that NEPs significantly reduce HIV transmission rates among injection drug users, their sexual partners, and children. States should be allowed to use their federal funds to support these programs which are a vital component of HIV prevention. This will not happen if the Secretary of HHS is not allowed to exercise her waiver authority to lift the ban!

AIDS Action:

Contact Representatives Dan Miller (R-FL), 202-225-5025 and Bill Young (R-FL), 202-225-5765 and, or make appointments with them in their district offices during the July 4th recess -- June 27th to July 7th -- and urge them to:

  • protect the HHS Secretary's waiver authority over the federal ban on needle exchange programs
  • support the largest increases possible for federal AIDS programs within the FY 98 Labor-HHS-Education appropriations bill - HIV prevention at the CDC, AIDS research at the NIH, all titles of the Ryan White CARE Act including the AIDS Drug Assistance Program (ADAP), and substance abuse prevention and treatment at SAMHSA

For more information, please contact Lisa White at 202-986-1300, ext. 3020.

Paid for with contributions from AIDS Action Network Members

AIDS Action Council
1875 Connecticut Avenue NW #700
Washington DC 20009
202-986-1300, extension 3053
202-986-1345 (fax)
202-332-9614 (tty)

A note from The field of medicine is constantly evolving. As a result, parts of this article may be outdated. Please keep this in mind, and be sure to visit other parts of our site for more recent information!

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  • Glossary Glossary

This article was provided by AIDS Action Council.
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